The Importance of Surveillance

Effective surveillance and timely reporting of diseases is essential in identifying an outbreak in action. It is crucial to collect high quality data in order to be able to understand the health status of a specific geographical area. Aside from outbreaks, surveillance aids public health professionals in understanding current and emerging infectious diseases. Without a clear grasp of the disease spread, it can be tough to tackle the issue at its root.

According to CDC, hepatitis C has nearly tripled between 2010 and 2015, the highest it has been in the past 15 years. In 2015, approximately 34,000 new hepatitis C infections were acquired and nearly 20,000 deaths have occurred from hepatitis C related causes. The most recent hepatitis C outbreak occurred in the state of Indiana due to an increase in injection drug use causing the state to declare a public health emergency. Hepatitis C surveillance is more important now than ever due to the rising opioid epidemic facing our country. This surveillance enables health departments to quickly identify acute cases of hepatitis C and respond in a timely manner.

The Allegheny County Health Department (ACHD) relies on laboratories and health agencies to report hepatitis C cases in a timely manner in order to spot any unusual patterns. ACHD began receiving a high number of HCV reports and due to efforts of an AmeriCorps National Health Corps member, we were able to find that the greatest risk factor for Allegheny County is injection drug use, as it is also nationally.

With the help of Pennsylvania National Electronic Disease Surveillance System (PA-NEDSS), ACHD is able to track incoming hepatitis C lab reports and add the data collected via the surveillance efforts. Due to majority of the reports being reported via laboratories such as LabCorps and Quest Diagnostics, we are not able to automatically collect information such as risk factors, symptoms, and treatments. My role constituted of contacting providers of those patients who fell under the protocol, to collect the above mentioned missing information.

ACHD needs to be able to clearly understand all aspects surrounding hepatitis C in the county in order to be able to break the barriers surrounding hepatitis C. For the past two years, ACHD has collected valuable data on hepatitis C, which can now be used to implement a new sentinel surveillance effort, and tackle any limitations to testing the high risk population faces. Many are getting preliminary screening tests but that poses as an issue when trying to access treatment, because it requires one to have confirmatory test completed. Many people with the most common risk factor, injection drug use, are getting tested, but what happens next? Are they getting referred for a rehab program for intravenous drug users? Do they have accessible medical treatment? Are they given access to other resources they need? These are the questions we hope to find answers to as the new sentinel surveillance is implemented.